PDQ cancer treatment information system

ABSTRACT

The Physician Data Query (PDQ) System is a clinically oriented computer data base developed to make recent information on cancer treatment widely available to the medical community. It represents an effort to promote diffusion of information about the treatment of cancer throughout the country, facilitates access to clinical trials, and accelerates the practical application of advances in research. The computer system provides information about state-of-the-art cancer treatment which is updated monthly by an editorial board. It also includes a file of active cancer-research protocols and directory of physicians and organizations providing cancer care to which physicians can gain access by geographic location. The PDQ system provides a search and display method in a simple menu driven process. Transmission of information about cancer over commercial telecommunication networks gives professionals easy access to the system through individual computer terminals.

The present invention is directed to an information dissemination systemand method for accessing information which links cancer research andclinical practice. The PDQ (Physician Data Query) Cancer TreatmentInformation System supplies physicians with up-to-date information oncancer treatment resources and other information, and makes suchinformation widely and readily available. This system creates a methodfor accessing medical information which involves a user-friendly menudriven interface to allow users to search and display informationwithout learning a specialized search language. Thus, currentinformation relating to a specific type of cancer is readily and easilyaccessible to a plurality of independent physicians.

BACKGROUND OF THE INVENTION

Following the passage of the National Cancer Act, the National CancerProgram, in addition to funding basic research, supported the trainingof cancer specialists and established a network of academic andcommunity-based cancer centers. In 1973, the first specialty boards inmedical oncology were administered. By 1980, the number of medical andradiation oncologists had increased from a few hundred specialists toseveral thousand. Further, by 1980, it had become evident the nationalmortality rate for a number of advanced, formerly fatal cancers, wasbeginning to fall as new and effective treatment regimes were beingincorporated into the care of patients with these diseases, at thecommunity level. Institutes ' (NCIs') programs, which monitor cancer

Five year survival data from the National Cancer incidents survival intwelve percent of the U.S. Population, indicated that survival for allpatients diagnosed with serious visceral cancer had increased from 38%in 1963 to 48% in 1980. Striking changes in survival were beingdocumented in patients with a number of disseminated cancers such asacute lymphocytic leukemia, Hodgkin's disease, soft-tissue sarcoma,testicular cancer, and a variety of other pediatric neoplasms in whichmajor breakthroughs in treatment had occurred, as well as in women withbreast cancer following adjuvant therapy. While survival data providedgratifying evidence that substantial progress against cancer had beenmade, they also emphasized that a five to ten year lag existed betweenthe identification of a curative therapy and its acceptance by themedical community and widespread application in patient care. Thisclearly suggested that significant increases in patient survival couldbe achieved with a wider and more rapid dissemination on informationeffective treatments.

A unique feature of the National Cancer Act of 1971 was a provision thatenabled the NCI to establish a National Network of resources that wouldfacilitate the development of effective methods to prevent, diagnose,and treat cancer. In addition, the Act gave NCI responsibility fordeveloping new improved methods to disseminate information on advancesin cancer research. However, the act included the words "insofar asfeasible" in its language and indicated that the Congress clearlyrecognize that there were obstacles in 1971 limiting the Institutes'ability to fulfill the mandate. For example, there were few trainedmedical radiation and pediatric oncologists either at academicinstitutions or in private practice to care for cancer patients anddevelop or deliver effective cancer treatments. There was a criticalneed for a network of institutions specializing in cancer care wherephysicians could send patients so that they would not have to travelgreat distances for treatment. For these reasons, the Congress gavespecial resources to NCI to develop treatment resources throughout thecountry and an information dissemination program to make the mostcurrent information on progress against cancer readily available.

Thereafter, an International Cancer Research Databank (ICRDB) wascreated to foster the rapid and effective exchange of information oncancer research throughout the world. NCI surveyed an internationalgroup of 250 basic scientists and clinical investigators in an attemptto define what services would best meet the needs of the internationalcancer research community. The Institute decided to build its newinformation program using computers so that the information could beupdated and enhanced over time The NCI developed CANCERLINE databases.These updatable files resided in machine-readible form in the memory ofa central computer which could be accessed by computers with softwarethat communicated with the central computer.

The first on-line information system, developed by the ICRDB program,was a bibliographic database called CANCERLIT, which was created in1974. The data base was composed of 42,000 citations taken fromCarcinogenesis Abstracts and Cancer Therapy Abstracts, two abstractjournals of the mid-1970s NCI then made CANCERLIT widely available tothe medical and scientific community over the National Library ofMedicine (NLM) computer system and searchable within a command languageused by the Medical Literature Analysis and Retrieval System (MEDLARS)databases. In an attempt to ensure CANCERLIT as a comprehensiveresource, many books and journals were screened, indexed and abstractedHowever, the CANCERLIT database did not provide information on researchin progress.

NCI then developed, through their staff of the ICRDB, a new computerizeddatabase called CLINPROT (Clinical Protocol), to disseminate informationon investigational treatment protocols supported by NCI. Each CLINPROTrecord was created using full clinical research protocol as the sourcedocument. Protocol summaries of 1000 to 5000 words were constructed,with special index terms that allowed users to receive protocols bytumor type and treatment. CLINPROT also used the specialized commandlanguage of the MEDLARS database While the CLINPROT database added a newdimension to research information, collective and disseminated, by theNCI, the protocol summaries were not indexed by stage, histolic type, orparticipating investigators and institutions. Therefore, it wasdifficult for physicians to identify clinical trials appropriate forcancer patients that were being conducted in a particular location.Further, CLINPROT did rot provide information on state-of-the-arttreatment CLINPROT merely served as an on-line catalogue on clinicalresearch that provided physicians who were designating treatmentprotocols with information on research performed by others, therebyminimizing duplication of effort. Further, as with all MEDLARSdatabases, effective information retrievals from CLINPROT requiredknowledge of the NLM's specialized searching language.

SUMMARY OF THE INVENTION

The present invention is directed to a system and method which solvesthe above-mentioned deficiencies known to have existed in the priorsystems. The PDQ cancer treatment information system is aclinically-oriented system developed to make recent information oncancer treatment widely available to the medical community. Itrepresents an effort by the NCI to promote diffusion of informationabout the treatment of cancer throughout the country, facilitate accessto clinical trials, and accelerate the practical application of advancesin research.

The computer system provides information about state-of-the-art cancertreatment, which is updated monthly by an editorial board. It alsoincludes a file of active cancer-research protocols and a directory ofphysicians and organizations providing cancer care to which physicianscan gain access by geographical location, as well by other means.

PDQ was designed for physicians who may not be familiar with computersto permit them to search for, and display information, without learninga specialized search language. PDQ utilizes a computer mainframe, whichallows a large amount of data to be stored and made available tophysicians rapidly and accurately. Transmission or information aboutcancer over commercial telecommunication networks gives healthprofessionals access to PDQ by means of a computer terminal and localtelephone lines.

Since a major goal was to provide up-to-date information on treatmentresearch, the PDQ system was also designed to provide explicit,clinically relevant information about research in progress, directingPhysicians to open clinical trials if no effective therapy existed. Toensure that PDQ is a comprehensive source of information about ongoingclinical trials, all active Protocol supported by the NCI areautomatically abstracted and entered into the system. In addition,clinical trials being performed without such support are solicited forinclusion in PDQ. At any time, the PDQ protocol file containsapproximately 1000 treatment protocols, twenty Percent of which havebeen voluntarily submitted. Each protocol is indexed according todisease and stage-specific eligibility criteria, as well as details oftreatment, to allow users to narrow down geographically classifiedinformation on participating investigators. Thus, physicians can easilyretrieve names, addresses, and telephone numbers of clinicalinvestigators according to location.

Further, PDQ's physician directory contains information of more than12,000 physicians and has an electronic computation of the membershipdirectories of seventeen professional societies established forphysicians who treat cancer. Clinical investigators whose protocols aresupported by the NCI, as well as those who are voluntarily submittedprotocols that have been accepted by the editorial board for inclusionin the PDQ protocol file, are also listed in the PDQ directory. EachPhysician's record includes his or her full name, address, telephonenumber, medical specialties, and organizational affiliations.

Still further, a directory of organizations with programs of cancer carehas been assembled. Also, because all physicians may not be familiarwith searching on computer systems, the PDQ software is designed toguide them through the data and allow them to retrieve information formore than one file by means of a series of simple "menus" and commands.These menus replace the difficult specialized searching language of theprior systems. A main menu allows physicians to chose from among thefollowing: a general description of the PDQ, instructions for searching,a news file, the membership of the PDQ editorial board, or one of thedata files (cancer treatment information, the directory of physiciansand organizations, or the protocol file) Menus in each file guidephysicians to the information that they seek, and from a technicalviewpoint, allow the software to map and retrieve information frommultiple data files in a manner that is transparent to users. Further,experienced users can bypass menus by entering a string of menuselections.

OBJECT OF THE INVENTION

It is therefore an object of the present invention to create acomputerized system which makes up to date information onstate-of-the-art cancer treatment widely and readily available.

It is a further object of the invention to provide an on-line source ofgeographically matrixed information on active research protocols and adirectory of physicians and organization to provide cancer care.

It is a further object of the invention to create a system which userscan identify the full range of treatment alternatives for all majorcancers, locate clinical trials for patients, and identify physiciansand treatment facilities for consultation and referral

It is a still further object of the invention to create a medicalinformation system to integrate divergent data files (state-of-the-arttreatment, protocols, medical literature, and directory information) byusing a user-friendly interface that permits retrieval of informationacross the files in a manner that is "transparent" to users and does notrequire the use of a structured search language.

It is a still further object of the invention to create cancerinformation files which contain treatment summaries that synopsisstate-of-the-art therapy for all major cancers by providing current dataon prognosis, relevant staging, histolic classifications, therapies thatconstitute the standard of care, and references to key literature.

Finally, it is an object of the invention to create a protocol filecontaining over 1000 clinical trials which compliment the cancerinformation file, with each protocol summary describing the studyobjectives and being indexed by disease and stage-specific eligibilitycriteria.

These and further objects of the present invention will become morereadily apparent from their understanding of the preferred embodimentsdescribed below with reference to the following drawing figures

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will become more fully understood from thedetailed description given hereinbelow and the accompanying drawingswhich are given by way of illustration only and are not intended tolimit the present invention, and wherein:

FIG. 1(a) illustrates the PDQ system for dissemination of information;

FIG. 1(b) illustrates a personal computer with a keyboard and display;

FIG. 2 illustrates a flowchart of the PDQ Main Menu for accessing theplurality of data files;

The above-mentioned drawing will be described in detail in the followingdetailed description.

DETAILED DESCRIPTION OF THE EMBODIMENT

FIG. 1(a) illustrates the Physician Data Query (PDQ) informationdissemination system. The system is a computer based system which makesinformation about state-of-the-art cancer treatment widely available tothe medical community. PDQ uses a computer mainframe (1), which allows alarge amount of data to be stored and made available to physiciansrapidly and accurately. Transmission of information about cancertreatment over commercial telecommunications lines (2), gives healthProfessionals access to PDQ by use of a computer terminal (3) hookedinto the lines (2).

Because it is increasingly difficult to keep abreast of the newdevelopments in cancer therapy, PDQ is a valuable resource for allclinicians, or those trained as cancer specialists. Information in PDQassists the physicians and other health professionals to identify andreplace knowledge that has become outdated or obsolete. State-of-the-artstatements provide a succinct overview of current data on prognosis,staging, and stage specific treatment options that can guide patientcare and facilitate the selection of an optimal treatment plan forpatients with cancer. Citations included in each section of thestate-of-the-art statements provide key references from scientificliterature that support the use of the therapy as a standard orinvestigational treatment in patients with that type and stage ofcancer. Information for patients concisely describes the prognosis,staging, classification, and treatment options in simple, easilyunderstood terms that facilitate its use as an educational research forpatients and their families during the diagnostic evaluation whentreatment decisions must be made.

The PDQ system is an on-line data base system which uses computertechnology to maintain the currency of information in the system. Thus,information from the extramural community on the medical content on thestate-of-the-art statements is continually maintained in a computermainframe (1). In maintaining the currency of the cancer informationfile, an editorial board constantly reviews voluntary protocolsubmissions, and the development of new state-of-the-art statements. Theboard further reviews information in a monthly basis from treatmentliterature, proposed modifications to PDQ statements, and needs toprepare additional state-of-the-art statements to enhance the file ofthe mainframe (1). New literature citations to support modifications cfstatements are regularly added. Further, directories for the physiciansand organizations also have their files maintained. Thus, accurateinformation is constantly input to the PDQ system on protocols,physicians and organizations.

The on-line system of PDQ allows Physicians to obtain access tostate-of-the-art information by merely utilizing a small computerterminal (3). FIG. 1(b) shows such a terminal which includes a keyboard(5) and a display screen (4). A physician need only connect to thesystem through local telecommunication lines and access it through hiscomputer screen (4). The PDQ system is one which is user-friendly andcontinually prompts a user through a series of menus which lead him tohis desired information. By merely choosing one of a plurality ofoptions from a menu displayed on a display screen (4), and inputting acorresponding numerical value through the keyboard (5), the PDQ systemwill guide any physician to information on state-of-the-art cancertreatment.

Table 1 illustrates the PDQ main menu, which is displayed on a displayscreen (4) of a user's terminal (3), upon accessing the PDQ system. ThePDQ system is one which is completely menu-driven. The system providesinformation about state-of-the-art cancer treatment which is updatedmonthly by an editorial board. The main menu, when prompted by the user,allows the user to select a number, from those shown on the main menu inTable 1, to retrieve one of a plurality of options.

The PDQ searching system was designed to guide users through data andallow them to retrieve information from more than one file by means of aseries of simple menus and commands. The "main menu" as shown in Table1, allows physicians to choose from among the following: (1) a generaldescription of the PDQ system; (2) instructions for searching; (3) anews file; (8) the membership of the PDQ editorial board; or (4) through(7), one of the existing data files (for cancer information, thedirectory of physicians, the directory of organizations, or the protocolfile). Further, (9) is directed to a means exiting the PDQ system.

Menus in each file guide physicians to the information that they seekand, from a technical viewpoint, allow software of the PDQ system to mapand retrieve information from multiple data files in a manner that istransparent to users. Further, experienced users can bypass menus byentering a string of menu selections (command "stacking" to be describedhereinafter). In addition, by entering simple commands, users can easilyreturn to previous menus and change files at will.

The PDQ main menu has a plurality of features, as described previouslywith regard to Table 1, but is mainly directed to providing a user witha selection of one or more various data files. These data files areshown in FIG. 2, for example, which illustrates a flow chart forretrieving information from each of the plurality of data files. Thefiles include the directory files, for either physicians ororganizations, and cancer treatment information files for listinginformation or obtaining cancer treatment by body location or a specificcancer type. Further, a list of literary citations is also included inwhich the PDQ system maintains information in the cancer-informationfile which contains abstracts of literature cited.

Next, a description of how the retrieval method of the PDQ systemoperates to retrieve information from the various data files, will begiven.

Initially, a physician will make a selection as to which of the variousdata files he wishes to access based on data obtained from a prospectivepatient. This patient data then directs the physician in selectingcorresponding data file numbers from the displayed PDQ main menu, asshown in Table 1. The selected number is then input through the terminalkeyboard (5). For example, a physician may desire to retrieveinformation on colon cancer based on data from a prospective patient. Toobtain information with which to treat a prospective patient, thephysician initially selects the cancer information data file from thedisplayed PDQ main menu, by entering "4" into the system. This selectionfrom the main menu, when entered, then prompts the display of asecondary menu. This allows the physician who chooses the cancerinformation file, to select one or more options from a series ofmultiple menus based on prospective patient data.

                  TABLE 1                                                         ______________________________________                                        PDQ MENU                                                                      The following information is available                                        in the PDQ Retrieval System:                                                  1 Description     5 Physicians                                                2 Instructions    6 Organizations                                             3 News            7 Protocols                                                 4 Cancer Information                                                                            8 PDQ Editorial Board                                       9 Exit PDQ                                                                    ______________________________________                                    

Once the physician (hereinafter referred to as the user) selects thecancer information file, a diagnosis selection menu is then displayed,as shown in Table 2. The diagnosis selection menu allows retrieval ofcancer information by accessing one of three categories. The user mayretrieve the information by body system or site, by selecting 1; byhistolic tissue or type, by selecting 2; or by childhood cancer, byselecting 3, based on known prospective patient data. This allows theuser to, by a selection from a sequential set of menus, accessinformation on a specific type of cancer, though the specific type ofcancer in a patient may not be known. For example, if the user knows thearea of the patient's body in which the cancer is present, he merelyselects the first category, "By Body System or Site".

                  TABLE 2                                                         ______________________________________                                        DIAGNOSIS SELECTION                                                                   1 By Body System/Site                                                         2 By Histologic Tissue/Type                                                   3 By Childhood Cancer                                                 ______________________________________                                    

Once the category of "By Body System or Site", has been chosen from thediagnosis selection menu and entered, a diagnosis selection by bodysystem or site menu is then prompted, as shown in Table 3. This allowsthe user to then select the particular body system or site whichcorresponds to cancer information desired to be retrieved to treat aprospective patient. The user can then select the particular body systemor site associated with the cancer, and can thus obtain accurateinformation based on the body system or site of the cancer.

                  TABLE 3                                                         ______________________________________                                        DIAGNOSIS SELECTION BY BODY SYSTEM/SITE                                       1      Acquired Immune Deficiency Syndrome (AIDS)                             2      Skin                                                                   3      Eye                                                                    4      Head and Neck                                                          5      Thorax/Respiratory                                                     6      Digestive/Gastrointestinal                                             7      Kidney/Urinary                                                         8      Musculoskeletal                                                        9      Hernatological                                                         10     Endocrine                                                              11     Male Reproductive                                                      12     Female Reproductive                                                    13     Breast                                                                 14     Neurological                                                           ______________________________________                                    

Upon the user selecting "Digestive or Gastrointestinal", by entering a 6into the system, a category specific menu on cancer in that area of thebody will then be prompted. As shown in Table 4, for example, a categoryspecific digestive/gastrointestinal cancer menu has been prompted anddisplayed. This menu is one in a series of menus directing the user to aspecific type of cancer in a step-by-step process. As previouslydescribed, if the user desires selecting information on colon cancer forpatient treatment, he can be directed to such information by theabove-mentioned series of menus Finally, upon reaching thedigestive/gastrointestinal cancer menu, he can select number 9 for coloncancer.

                  TABLE 4                                                         ______________________________________                                        DIGESTIVE/GASTROINTESTINAL CANCER                                             1         Esophagus                                                           2         Stomach                                                             3         Liver and Intrahepatic Biliary Tract                                4         Gallbladder                                                         5         Extrahelatic Biliary                                                6         Pancreatic (exocrine)                                               7         Small intestine                                                     8         Gastrointestinal Carcinoid Tumor                                    9         Colon                                                               10        Rectum                                                              11        Anal                                                                ______________________________________                                    

Upon selecting the appropriate type of cancer for which information isdesired, the cancer information menu on colon cancer, as shown in Table5, will be displayed. This is a menu which directs the user to all theavailable categories of information concerning a specific type ofcancer. Prognostic and treatment information contained in"state-of-the-art" statements and the "information for patients"sections are selectable from a menu that is dynamically generated whenthe user selects a particular cancer to be diagnosed. The user canobtain information for determining what a particular state a patient'sspecific type of cancer may be in, and general treatment informationoptions for that state. Further, state-of-the-art prognosis informationis available as is information, once a particular stage of the cancerhas been diagnosed, on treatment of a patient with cancer in thatparticular stage. Thus, a prospective patient can be treated inaccordance with the diagnosis information obtained. Also stage-specifictreatment option selection also concludes with a statement on the numberof protocols that are currently in the PDQ protocol file which areindexed for that stage.

                  TABLE 5                                                         ______________________________________                                        CANCER INFORMATION MENU                                                       COLON CANCER                                                                  Patient Education State-of-the-Art Information                                1   Prognostic Statement                                                                          4     Prognosis                                           2   Stage Explanations                                                                            5     Cellular Classification                             3   General Treatment                                                                             6     Stage Information                                       Options         7     Treatment by Cell                                                             Type/Stage                                          8        Display All Information                                              9        Continuation Options to Select                                                Physicians, Organizations, or Protocols                              ______________________________________                                    

Further, PDQ also provides a continuation option to make it convenientfor users to move from the cancer information file to other files. Alist of the continuation options, for a user who selects information oncolon cancer, is shown in Table 6. Thus, the user can jump from thecancer information file to one which lists the directory of physicians,organizations, or to a list of protocols to further aid in patienttreatment.

                  TABLE 6                                                         ______________________________________                                        CONTINUATION OPTIONS                                                          COLON CANCER                                                                  The following options are available for                                       continuing your search.                                                       Your cancer diagnosis will be used automatically                              if you choose option 3 for protocol retrieval.                                           1 Physicians                                                                  2 Organizations                                                               3 Protocols                                                        ______________________________________                                    

Throughout the PDQ search, users may elect to return to a previous menu,change files, restart from the PDQ main menu, or exit from PDQ byentering a simple command. In addition, command stacking in all PDQfiles allows experienced searchers to bypass menus at most prompts byentering a string of commands that are formulated into a query by theretrieval software.

For example, the user, who is familiar with the system, can accessinformation on colon cancer merely by entering the search term "colon"or the first few letters of the diagnostic with a truncation system (:)at the prompt. Therefore, with this term entered into the system, thePDQ system will then skip many of the intermediate menus, and displayonly the cancer information menu. Thus, the user can obtain informationquickly on a specific type of cancer. However, the main emphasis of thePDQ system is designed to allows users who are not extremely familiarwith the system to obtain information in a step-by-step menu drivenprocess. Further, it allows the user to obtain information based on aspecific type of diagnosis selection as shown in FIG. 4, when he isunsure of the specifics of the cancer.

The PDQ system also allows users to obtain information from variousdirectory data files listing various physicians and organizationsthroughout the country. The physician directory, as shown in Table 7,currently contains information on more than eleven thousand physicianswho devote a major portion of their clinical practice to treatment ofcancer patients. The directory is an electronic compilation of themembership directories of sixteen national medical societies establishedfor physicians who treat cancer. The societies have listed theirphysician members in the PDQ files. Clinical investigators whoseprotocols have been supported by NCI, as well as those who voluntarilysubmitted protocols that have been accepted by the PDQ editorial boardfor inclusion in the PDQ protocol file, are also listed in the PDQdirectory. Each physician's record includes his full name, address,telephone number, medical specialities, and organizational affiliations.

Users can retrieve information about physicians by entering one of thefollowing: 1, the physician's name; 2, a medical specialty; and 3-6, aparticular geographic location. This PDQ physician retrieval menu, aspreviously described, is shown in Table 7. Once an individual physicianor subset of physicians is defined, users are offered a variety ofprint/display options that enable them to review the retrieval recordsin varying degrees of detail. Treatment protocols for which a physicianis a principal investigator can also be retrieved, since the PDQ systemautomatically links the physician record to the appropriate records andother data files.

                  TABLE 7                                                         ______________________________________                                        PDQ PHYSICIAN RETRIEVAL                                                       You may narrow set of physicians by                                           ______________________________________                                                  1 Physician Name                                                              2 Medical Specialty                                                           3 State                                                                       4 City                                                                        5 Zip Code                                                                    6 Non-U.S. Country                                                  ______________________________________                                    

Similar to the physician directory, there is also an organizationdirectory. The organization directory includes information on more thanfourteen hundred health care organizations and institutions at which theNCI supports clinical treatment and hospitals with established cancerprograms. Information on organizations can also be retrieved by name orby specific geographic location using state, city, or zip code. Eachorganization record includes the address, telephone number, and name ofa person at the institution who has agreed to serve as the PDQ contactand can answer questions about the organization's cancer treatmentprogram and facilities. As in the physician's directory, PDQ usesfile-to-file linkages to automatically display all active protocols fora specific organization if requested by the user.

A final data file which exists is the protocol file. The protocol filecurrently contains information on more than one thousand activetreatment protocols being conducted in the United States. All activetreatment protocols directly supported by the NCI are automaticallysummarized and entered. Further, twenty percent of the protocols havebeen voluntarily submitted for inclusion into the PDQ system. Protocolscan be retrieved by diagnosis, stage, identification number, treatmentmodelity, key words from the protocol title, and location using one ormore state postal codes. This protocol retrieval process can be seen,for example, in Table 8.

                  TABLE 8                                                         ______________________________________                                        PDQ PROTOCOL RETRIEVAL                                                        2 protocols retrieved                                                         DIAGNOSIS = BREAST CANCER                                                     STAGE = STAGE II                                                              KEYWORD(S) = POSTOPERATIVE                                                    PHASE(S) = PHASE III                                                          MODALITY = RADIATION AND CHEMOTHERAPY                                         STATE = NY.NJ.CT                                                              You may narrow set of protocols by                                            1     ID Number                                                               2     Cancer Diagnosis                                                              (use NARROW to decrease number of protocols)                            3     State of Disease                                                        4     Phase of Protocol                                                       5     Treatment Modality                                                      6     Drug Name                                                               7     State                                                                   or you may                                                                    8     Erase Existing Selection Criteria                                       9     Display Current Set of Protocols                                        ______________________________________                                    

Each protocol record includes details description of the objectives ofthe study, patient eligibility requirements, description of thetreatment regime, details about dose and schedule of the administration,and information about who is performing the clinical trial and where itis being conducted.

The PDQ Protocol file can be accessed in a plurality of ways. The usermay select the protocols for a particular cancer diagnosis and stage bychoosing the continuation option on the cancer information menu for thatdiagnosis, as previously described. This option enables the user tocarry a search from the cancer information file into the protocol file.All of the clinical files that accept patients with that stage or celltype of cancer are automatically retrieved from the PDQ protocol filewithout reformulating the search statement.

Users may further select protocols as a primary retrieval option fromthe PDQ main menu. When this option is used, a menu is presented thatenables users to select protocols by cancer diagnosis, stage, drug,treatment modelity, key words in the protocol title, phase of clinicalinvestigation, or any combination of these parameters to generate a listof protocols accepting patients which meet the search criteria. Everyprotocol that is being conducted, within the parameters that have beenspecified, may be retrieved and reviewed, or the user may narrow theretrieval protocols to one or more states, to select only those that arebeing conducted in a specific location.

Each time a protocol set is defined, PDQ informs the user how manyprotocols, meeting the search criteria, have been retrieved. At anypoint, the user may either redefine the search criteria or decide todisplay and Print protocol information in varying degrees of detail byselecting one of the print display options. These various print displayoptions are shown in Table 7. These commands allows the user to print aslittle as a listing of protocol titles or as much as entire protocolsummaries with listing of all participating investigators. Users canalso customize their own print/display format from a menu containing allprotocol elements.

                  TABLE 9                                                         ______________________________________                                        PROTOCOL DISPLAY OPTIONS                                                      1 BROWSE Through protocol titles wit option to select one                              or more protocols for display.                                       2 SHORT  Display all protocols in short format.                               3 MEDium Display all protocols in medium format.                              4 NAMES  Display all protocols and investigators.                             5 LONG   Display all protocols in long format.                                6 CUSTom Display all protocols in custom format.                              7 Return To protocol menu.                                                    ______________________________________                                        . . . . . . . . . . . . . . . . . . . . . . . .                               HELP SCREEN                                                                   Format   Function                                                             BROWSE   Display protocol names and id-numbers with                                    option to select one or more for deferred                                     printing in short, medium name or long format.                       SHORT    Display protocol id-number, name and protocol                                 chairman name and address for all retrieved                                   protocols.                                                           MED      Display same information as short format plus                                 protcol entry criteria and objectives.                               NAMES    Display same information as medium format plus                                name and address information for protocol                                     investigators.                                                       LONG     Display all protocol information for all                                      retrieved protocols.                                                 CUST     Display selected information for all retrieved                                protocols, in user defined order.                                    ______________________________________                                        Shortcut: to bypass the protocol print menu FROM THE                          PROTCOL SELECTION MENU, type the key word associated                          withthedesiredformat,e.g.,BROWSE,SHORT,MED,orLONG                         

A list of protocol data elements is shown in Table 10. These elementsinclude objectives, entry criteria, warnings, and a plurality of othersas shown in Table 10. Users can select any number of items, in anyorder, and can maintain their customized print format for an entiresearch session or redefine a format at will.

                  TABLE 10                                                        ______________________________________                                        PROTOCOL DATA ELEMENTS                                                                1   Objectives                                                                2   Entry Criteria                                                            3   Warning                                                                   4   Outline                                                                   5   Stratification                                                            6   Special Study Parameters                                                  7   End Points                                                                8   Projected Accrual                                                         9   Dosage Schedule                                                           10  Dosage Forms                                                              11  Participants                                                      ______________________________________                                    

The PDQ protocol file provides up-to-date information on investigationaltreatment options, that is especially valuable to clinicians when noeffective standard therapy exists and patients should be offeredinvestigational therapies. Because protocol retrievals can be tailoredto specific clinical situations, PDQ can perform a physician with a"snapshot" of clinical research being conducted in that disease whichcan then be narrowed to a "closeup" of those being conducted andspecific location. This enables physicians to identify appropriateclinical trials with knowledgeable investigators who can be conductedfor consultation or referral.

The PDQ directory file of physicians and organizations provides anelectronic telephone book of clinical resources that enhancescommunication among cancer care providers. The ability to retrievedirectory information by city, state or zip code can facilitate therapid identification of treatment resources that are available forpatients in a specific geographical area.

Through the use of the PDQ cancer treatment system, a physician canobtain appropriate information to treat a cancer patient.State-of-the-art information is made readily available and easilyaccessible to all physicians. Further, information on local expertphysicians or organizations may be obtained to aid in obtainingtreatment information. Thus, PDQ disseminates up-to-date cancertreatment throughout the medical community.

From the above-described embodiments of the present invention, it isapparent that the present invention may be modified as would occur toone of ordinary skill in the art without department from the spirit andscope of the present invention which should be defined solely by theappendent claims. Changes and modifications of the system contemplatedby the present preferred embodiments will be apparent to one of ordinaryskill in the art.

What is claimed is:
 1. A method of accessing medical information,relating to cancer, for cancer treatment of a prospective patient,comprising the steps of:a) obtaining data describing a prospectivepatient; b) displaying a first menu of a plurality of types ofinformation; c) selecting an information type from said first menurelating to a type of information, based on said prospective patientdata; d) displaying a second menu of a plurality of diagnosis sectionsrelating to said selected information type; e) selecting a diagnosisselection from said second menu relating to a type of diagnosis, basedon said prospective patient data; f) displaying a third menu of aplurality of body-area categories relating to said selected diagnosis;g) selecting a body-area category from said third menu relating to anarea of the prospective patient's body, corresponding to said selecteddiagnosis type, based on said prospective patient data; h) displaying afourth menu of a plurality of types of cancer diagnosable in saidselected body area; i) selecting a cancer type, from said fourth menu,for which medical information is desired to treat said prospectivepatient, based on said prospective patient data; and; j) outputtingmedical information relating to said selected cancer-type; k) treatingsaid prospective patient based on said output medical information.